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Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
@celinegounder
Nov 18, 2019 • 7 tweets • 4 min read • Read on X
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Now this is impact (thread). All lawsuits citing my 2013 @NewYorker piece on the #opioidepidemic. newyorker.com/business/curre… Learn more on Season 2 of insicknessandinhealthpodcast.com. Image
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@NewYorker And also this (not a lawsuit): Image

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More from @celinegounder

Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
May 10
1/ #H5N1 news today 📢📢📢

@USDA has announced an indemnification program for dairy farms to be based on the amount of milk🥛 lost from cows🐄 sick with H5N1.
2/ @USDA will also offer farmers support for biosecurity measures on the farm:
🔹to protect against potential spread between animals 🐄 & humans🧑‍🌾: PPE &/or outerwear laundering services
🔹to make biosecurity plans
🔹to pasteurize milk🥛 before disposal
3/ @USDA will also offer farmers support for biosecurity measures on the farm (continued):
🔹to offset costs of veterinary care for sick cattle🐄
🔹to offset costs of shipping samples for testing🧪
Read 15 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
May 9
1/ The @US_FDA is taking precautions in case the H5N1 bird flu starts spreading from person-to-person, possibly igniting an epidemic/pandemic.

with @CBSNews @AMGreenCBS

cbsnews.com/video/fda-prep…
2/ Long before the COVID pandemic, infectious disease experts like me have worried about the possibility of an influenza pandemic.

The 1918 flu pandemic, which is estimated to have killed 50 to 100 million people worldwide, is one of the deadliest in human history.
3/ H5N1 bird flu viruses have long given us pause, our leading candidates for the next big flu pandemic.

They were first detected in poultry in China in 1996 & quickly spread throughout the region.
Read 17 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Apr 29
1/ H5N1 bird flu candidate vaccine viruses have been identified:
(jump to 1:33)
🔹2 are "well-matched" to H5N1 infecting dairy cattle
🔹but how "well-matched" are they really? this conclusion is based on ferret dataastho.org/education/hpai…Image
2/
 🔹Candidate vaccine viruses are used to make antigen (i.e. the target you want the immune system to see) for vaccines.
🔹Adjuvant has also been stockpiled.
🔹Adjuvants help strengthen the immune response to antigen in vaccines. Image
3/
🔹100s of thousands of doses of candidate antigen + adjuvant have been manufactured for use in clinical studies.
🔹2 safety/immunogenicity studies are being conducted.
🔹@ASPRgov is working with @US_FDA & industry to figure out a regulatory pathway for the use of these doses.
Read 4 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Apr 29
1/ There are still lots of unanswered questions re: H5N1 bird flu

🔹How quickly is the virus mutating and evolving?

A PB2 E627K mutation was found in the human case in Texas, but not seen in birds or cows.
(1:04:50)astho.org/education/hpai…
2/ The PB2 E627K mutation has been seen in other human cases of H5N1.

It is one step towards mammalian (but NOT human) adaptation in experimental studies. (h/t @RickABright)
3/ The PB2 E627K mutation may have developed in the human Texas case.

It has not been seen in Texas dairy cattle or birds, nor in wild birds or poultry.
Read 8 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Apr 25
1/ Stemming the spread of H5N1 bird flu
🔹The federal government is ramping up testing of dairy cows
🔹Cows will now have to be tested before being transferred to another state
🔹H5N1 viral fragments detected in grocery store milk
🔹The risk to humans remains low at this time
2/ Remember PCR tests from COVID?

They can be positive even after you’ve recovered because they’re picking up dead virus.

Some PCR tests on pasteurized milk from grocery stores have come back positive for bird flu... but that could just be dead virus.
3/ Pasteurization has worked for over a hundred years to protect consumers from bacteria and viruses.

There’s no reason to think pasteurization won’t also work to kill the bird flu virus, but scientists are confirming that with testing anyway.
Read 16 tweets
Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Apr 23
1/ H5N1 bird flu has been detected in the milk supply




We currently believe the milk supply to be safe.

Some other key points:washingtonpost.com/health/2024/04…
nytimes.com/2024/04/23/hea…
fda.gov/food/alerts-ad…
2/ The levels of virus fragments being found in milk by PCR are high.

Milk from different cows is combined into big vats.

You wouldn't see such high levels of virus if only a couple cows were infected... it would be diluted down.

This implies many cows have been infected.
3/ I suspect there's been a ton of asymptomatic transmission among cows.

They've only been testing symptomatic cows.
Read 8 tweets

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